RESEARCH PAPER
Analysis of socioeconomic factors and their influence on the incidence of complications in patients with acute coronary syndrome in Warmia and Mazury Province
 
More details
Hide details
1
Department of Internal Medicine, Gastroenterology and Hepatology with Cardiology Unit and Centre for the Treatment of Heart Failure and Cardioncology, Clinical University Hospital in Olsztyn, Poland
CORRESPONDING AUTHOR
Beata Moczulska   

Department of Internal Medicine, Gastroenterology and Hepatology with Cardiology Unit and Centre for the Treatment of Heart Failure and Cardioncology, Clinical University Hospital in Olsztyn,Warszawska 30, 10-082 Olsztyn, Poland. Tel.: +48 608 690 980.
Submission date: 2014-06-27
Acceptance date: 2015-03-26
Online publication date: 2015-04-19
Publication date: 2020-03-24
 
Pol. Ann. Med. 2015;22(1):30–34
 
KEYWORDS
ABSTRACT
Introduction:
Socioeconomic status (SES) has the influence on the course and prognosis of acute coronary syndrome (ACS).

Aim:
Assessment of the effect of certain socioeconomic factors on the incidence of cardiovascular complications of ACS during hospitalization and 3-month follow-up.

Material and methods:
Patients enrolled in the study had ACS, diagnosed by ECG changes, positive markers of myocardial damage and angiography: ST segment elevation myocardial infarction (STEMI), non-ST segment elevation myocardial infarction (NSTEMI), and unstable angina (UA). Patients were given questionnaires regarding place of residence, education, occupation, and work status. The incidence of complications of ACS during hospitalization and 3-month follow-up was evaluated.

Results and discussion:
The study included 160 subjects (30 female and 130 male) aged 57.6 ± 9.4 years. 70% of patients had STEMI, 18% NSTEMI, and 12% UA. In the study group 72% of patients lived in cities, 57.5% of patients had primary or vocational education. Men significantly more frequently had primary and vocational education in comparison with women (P < 0.005). 48% of patients were active workers, 66% of whom had physical work. The remaining subjects (52%) were not working with disability pension (25%) and retirement pension (75%). Men were significantly more frequently on pension than women (P < 0.033). Complications of ACS during hospitalization were observed in 56 patients (35%), after 3-month follow-up in 26 (16%) patients. Having a job before the occurrence of ACS correlates with a higher incidence of complications both during hospitalization and a 3-month follow-up (P < 0.04).

Conclusions:
High rates of unemployment in Warmia and Mazury Province probably force patients to return to work shortly after ACS episode.

CONFLICT OF INTEREST
None declared.
 
REFERENCES (19)
1.
Firych P, Grossmann G, Klecha T. Extensity of coronary arteries changes in correlation with selected predictors of coronary heart disease among coronary syndromes patients in city and agriculture population. Ann UMCS Sect D. 2004;59(Suppl 14):77–81.
 
2.
Gerber Y, Benyamini Y, Goldbourt U, Drory Y. Neighborhood socioeconomic and long-term survival after myocardial infarction. Circulation. 2010;121:375–383. http://dx.doi.org/10.1161/CIRC....
 
3.
Gerber Y, Goldbourt U, Drory Y. Interaction between income and education in predicting long-term survival after acute myocardial infarction. Eur J Cardiovasc Prev Rehabil. 2008;15(5):526–532. http://dx.doi.org/10.1097/HJR.....
 
4.
Jakobsen L, Niemann T, Thorsgaard N, et al. Dimensions of socioeconomic status and clinical outcome after primary per cutaneous coronary intervention. Circ Cardiovasc Interv. 2012;5(5):641–648.
 
5.
Szwed H. [Electrocardiographic changes in acute coronary syndromes]. In: Opolski G, Poloński L, Filipiak KJ, eds. In: [Acute coronary syndromes]. Wrocław: Urban & Partner; 2002:40 [in Polish].
 
6.
Judkins MP. Selective coronary arteriography. I. A percutaneous transfemoral technique. Radiology. 1967;89(5):815–824.
 
7.
Zdrojewski T, Rutkowski M, Bandosz P, et al. Prevalence and control of cardiovascular risk factors in Poland. Assumptions and objectives of NATPOL 2011 Survey. Kardiol Pol. 2013;71(4):381–392.
 
8.
Drygas W, Kwaśniewska M, Szcześniewska D, et al. Assessment of physical activity of Polish adult population. The results of WOBASZ programme. Kardiol Pol. 2005;63(suppl 4):636–640 [in Polish].
 
9.
Poloński L, Gąsior M, Gierlotka M, et al. Polish Registry of Acute Coronary Syndromes (PL-ACS) characteristics, treatments and outcomes in patients with acute coronary syndrome in Poland. Kardiol Pol. 2007;65(8):861–871.
 
10.
Kaplan GA, Keil JE. Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation. 1993;88(4 Pt 1):1973–1998.
 
11.
Rundek T, Brown DL. Socioeconomic status and subclinical atherosclerosis: are we closing disparity gaps? Stroke. 2014;45:948–949. http://dx.doi.org/10.1161/STRO....
 
12.
Alter DA, Naylor CD, Austin P, Tu JV. Effects of socioeconomic status on access to invasive cardiac procedures and on mortality after acute myocardial infarction. N Engl J Med. 1999;341(18):1359–1367.
 
13.
Philbin EF, McCullough PA, DiSalvo TG, Dec GW, Jenkins PL, Weaver WD. Socioeconomic status is an important determinant of the use of invasive procedures after acute myocardial infarction in New York State. Circulation. 2000;102(19 suppl 3):107–115. http://dx.doi.org/10.1161/01.C....
 
14.
Salomaa V, Miettinen H, Niemela M, et al. Relation of socioeconomic position to the case fatality, prognosis and treatment of myocardial infarction events; the FINMONICA MI Register Study. J Epidemiol Community Health. 2001;55:475–482. http://dx.doi.org/10.1136/jech....
 
15.
Lundin A, Falkstedt D, Lundberg I, Hemmingsson T. Unemployment and coronary heart disease among middle-aged men in Sweden: 39 243 men followed for 8 years. Occup Environ Med. 2014;71(3):183–188. http://dx.doi.org/10.1136/oeme....
 
16.
Senan M, Petrosyan A. The relationship between socioeconomic status and cardiovascular events. Georgian Med News. 2014;227:42–47.
 
17.
Shi WY, Yap XH, Newcomb AE, et al. Impact of socioeconomic status and rurality on early outcomes and mid-term survival after CABG: insights from a multicentre registry. Heart Lung Circ. 2014;23(8):726–736. http://dx.doi.org/10.1016/j.hl....
 
18.
Wang JY, Wang CY, Juang SY, et al. Low socioeconomic status increases short-term mortality of acute myocardial infarction despite universal health coverage. Int J Cardiol. 2014;172(1):82–87. http://dx.doi.org/10.1016/j.ij....
 
19.
Dziemianowicz W, Szmigiel K, Charkiewicz J, Dąbrowska A. [Analysis of the situation in the region based on existing data: analysis of test results on the level of innovation in 2004–2008]. Warszawa: Geoprofit; 2009 ris.warmia.mazury.pl/userfiles.... Accessed 24.02.2015.